HARVARD BULLETINS 
IN EDUCATION 

Graduate School of Education 
Harvard University 



NUMBER VII 



NOVEMBER, 1920 



SIGHT-SAVING CLASSES IN THE 
PUBLIC SCHOOLS 

BY 

R. B. IRWIN 

i ISOR, DEPARTMENT FOR THE BLIND 
CLEVE1 AND PUBLIC SCHOo 




PUBLISHED BY HARVARD UNIVERSITY 
CAMBRIDGE, MASS. 



HARVARD BULLETINS IN 
EDUCATION 



NUMBER VII 



HARVARD BULLETINS IN EDUCATION 

I. The School System as an Educational Lab- 
oratory. By Wm. S. Learned. 25 cents. 

II. Scales for the Measurement of English Com- 
position. By Frank W. Ballou. 50 cents. 

III. Bridging the Gap: The Transfer Class. By 
F. W. Wright. 30 cents. 

IV. A Selected Critical Bibliography of Voca- 
tional Guhxance. By John M. Brewer and Roy 
W. Kelly. 50 cents. 

V. A Descriptive Bibliography of Measurement 
ln Elementary Subjects. By Henry W. Holmes 
and others. 50 cents. 

VI. Business Practice in Eiementary Schools. 
By Roy Davis. 50 cents. 



HARVARD BULLETINS IN EDUCATION 

SIGHT-SAVING CLASSES IN 
THE PUBLIC SCHOOLS 

BY 
R. B. IRWIN 

SUPERVISOR, DEPARTMENT FOR THE BLIND 
CLEVELAND PUBLIC SCHOOLS 




This Bulletin is issued under the auspices of the 
Schools Committee of the Associated Harvard Clubs 



PUBLISHED BY HARVARD UNIVERSITY 
CAMBRIDGE, MASS. 



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COPYRIGHT, 1920 
HARVARD UNIVERSITY 



DEC 30152: §> CU605253 



FOREWORD 

The publication of this Bulletin is made possible through the gen- 
erous support of Mr. Murray Seasongood, 'oo, of Cincinnati, 
Chairman of the Schools Committee of the Associated Harvard 
Clubs. 

Readers of this monograph will be interested to know that the 
author, Mr. R. B. Irwin, himself blind, is to be one of the lecturers 
in an extension course on the Education of the Blind, undertaken 
in 1920 by the Graduate School of Education, Harvard Univer- 
sity, with the cooperation of the Massachusetts Department of 
Education, Division of the Blind, the Perkins Institution for the 
Blind, and the Association for the Promotion of the Interests of 
the Adult Blind. Inquiry concerning this course may be ad- 
dressed to the Graduate School of Education, Lawrence Hall, 
Cambridge, Massachusetts. 



INTRODUCTION 

Like a shaft of sun penetrating their twilight has come the Sight 
Saving Class to our visually handicapped school children. 

Parents, educators, in fact the general public look upon all 
children who are not definitely blind as having normal eyesight. 
Only the few who have had the fact forcibly brought to their at- 
tention realize the existence of a third group — the children 
whose light is darkened. So, little ones whose eyesight is reduced 
to one-third, one-quarter, or even a tenth of normal are required 
with the same equipment to meet the standards reasonably de- 
manded of the unhandicapped child. 

The Sight Saving Class seems the reasonable solution for these 
most unfortunate of children. Probably no one knows this sub- 
ject better than Mr. Irwin who has been associated with the work 
practically since its beginning and has also known schools for the 
blind since his early childhood. He tells us concisely the causes of 
visual disability in school children and the methods for overcom- 
ing their impediment. 

These classes for conservation of vision are slowly but steadily 
becoming established in our larger cities. The improvement in 
general physical condition and scholarship justifies the trouble 
and additional expense incurred in conducting these special 
classes. 

Ida E. Ridgeway, 

Supervisor of Work for Children, 

Massachusetts Department of Education , 

Division of the' Blind. 



SIGHT-SAVING CLASSES IN THE 
PUBLIC SCHOOLS 



SIGHT- SAVING CLASSES IN THE 
PUBLIC SCHOOLS 

School medical inspection has disclosed the existence in every 
school population of a certain proportion of pupils who, though 
not blind, are seriously handicapped in their school work by rea- 
son of marked defects of vision. These pupils can read ordinary 
school books, but any continued use of such material is attended 
by so much strain of the eyes and general nervous system as to 
jeopardize their sight and general health. The operation of our 
compulsory education laws has brought these pupils forcibly to 
the attention of school and health authorities. 

Eye defects in such cases are as follows: (i) those which cause 
a considerable dimness of vision, but which are more or less static 
in nature, such as scars or opaque spots on the cornea or trans- 
parent part of the eye; (2) those which do not cause a marked 
reduction in visual power, but which grow progressively worse 
under unfavorable conditions, such as progressive myopia, or 
near-sight, which is likely to result in the tearing away of the 
inner and most important part of the wall of the eye, the retina or 
nerve layer. The proportion of pupils having such visual defects 
varies in different places from one to every five hundred of the 
school population in the smaller cities to one to one thousand of 
the school population in the larger cities. While the number of 
such pupils is small, it is two or three times as large as is the 
number of blind children. Furthermore, our neglect of this class 
has made it a fruitful field from which to recruit the ranks of the 
blind in later life. 

Many of these pupils have had a hopeless prospect in the past. 
Some of them who have had the good fortune to fall in with con- 
siderate teachers and who have had wise parents have managed to 
get through school with few ill effects. Others have worried along, 
always at the foot of the class, repeating every other year, study- 



12 HARVARD BULLETINS IN EDUCATION 

ing when their eyes would permit, blurring when their eyes would 
not, idling away their time, and when their self-respect asserted 
itself, playing truant. Some of these pupils eventually drop out of 
school either with or without a doctor's certificate. Other pupils 
of this class sooner or later find their way into a school for the 
blind. In such schools they are no less misfits than they are in the 
regular classes in the public schools. Schools for the blind accept 
them, not because it is felt that they belong in such institutions, 
but because there seems to be no other place to send them. 

In the school for the blind the approach is through the fingers. 
Every pupil must learn to read by touch. At first, these "seeing " 
pupils make a serious effort to cooperate with the teachers, but 
the process of finger reading is so clumsy, and reading with the 
eyes is so easy that they soon supplement touch with sight. 
From this time forward, it becomes a test of persistence between 
the teacher and the pupil, in which the child generally wins. In 
time the teacher comes to wink at the practice of reading the 
raised white dots by sight. Eventually many of these pupils 
appear in class with an ink print book from which they read 
openly. 

Naturally schools for the blind give little attention to the proper 
source and quantity of schoolroom lighting. In one of our best 
residential schools for the blind every classroom has a southern 
exposure. These rooms are flooded most of the day with bright 
sunshine which produces a glare intolerable to the child with weak 
eyes. Other schools for the blind have a very inadequate supply 
of natural fight, and practically no artificial light is provided. 
Consequently many of those who enter the school for the blind 
with considerable sight read with their fingers cheerfully before 
they graduate as they have no other means of reading. 

Early in the second decade of the twentieth century, interest 
in the problem of adapting public school methods to the needs of 
pupils with a high degree of visual defect was manifested not 
only in several parts of the United States, but also in England and 
in Germany. Although the class opened in London at the instiga- 
tion of M. Bishop Harmon in 1909 was primarily for the treat- 
ment of myopic patients, an increasing percentage of pupils with 




Reading Braille with Weak Eyes Causes Dangerous' Eye-Strain 



14 HARVARD BULLETINS IN EDUCATION 

other visual defects has been admitted in order to aid them in 
their school work. 

In 191 1 pupils having considerable vision who had been as- 
signed to classes for the blind in Cleveland were permitted to 
make a moderate use of the blackboard and of school text-books 
under the direct supervision of the school oculist. 

In the spring of 19 13, the city of Boston opened a class for so- 
called "semi-seeing" children. This step was taken at the urgent 
request of the Perkins Institution for the Blind which continued 
for years to extend to these classes and other similar classes in 
Massachusetts much financial and moral support. 

In the fall of 19 13, the city of Cleveland removed from its 
classes for the blind all pupils who had been taught through their 
eyes rather than through their fingers, and organized them into 
special classes known as conservation of vision or sight-saving 
classes. A little later Cincinnati, Toledo, and several other Ohio 
cities opened up similar classes. During the same period several 
Massachusetts cities followed the lead of Boston and made 
similar provision for their pupils with defective vision. New 
York City opened a few of these classes as an experiment, and 
soon became so flooded with applicants that those in charge of 
the department almost despair of meeting the demand. Re- 
cently Detroit, Grand Rapids, Minneapolis, Duluth, Rochester, 
Buffalo, Philadelphia, Halifax, Nova Scotia, and other cities have 
organized conservation-of- vision classes. Milwaukee has adopted 
the special method of instruction used in sight-saving classes, but 
as yet has not separated the partially sighted from those who are 
blind. 

Few innovations in educational methods have met with so much 
universal approval as has the separation for instruction purposes 
of blind and partially blind pupils. Schools for the blind, state 
commissions for the blind, city societies for the blind, and the 
National Committee for the Prevention of Blindness have pro- 
moted this movement with energy and enthusiasm. Illinois, 
Massachusetts, Minnesota, New York, Ohio, Pennsylvania, and 
Wisconsin have enacted state laws providing financial assistance 
to cities conducting such classes. 




Unrestricted Reading in this Way is not only Painful but 
Dangerous 



1 6 HARVARD BULLETINS IN EDUCATION 

Sight-saving class departments have three fairly definite aims: 
first, to instruct the pupils with a minimum of eye-strain; sec- 
ond, to teach them how to conserve the vision they possess; and, 
third, to provide such vocational guidance, and, if necessary, vo- 
cational training as will enable them to fill the most useful places 
in the community their powers will permit. 

The most common method of procedure in establishing a sight- 
saving class is to designate a public school building as a conserva- 
tion-of-vision school. To this building are assigned eight or ten 
children seriously handicapped in regular school work by reason 
of defective vision. They possess sufficient sight, however, to 
enable them to make some use of ordinary book print. In de- 
veloping this work, care is usually taken not to set these children 
apart from others any more than is necessary. The regular or- 
ganization of the school is disturbed as little as possible, and not 
more than twelve pupils are assigned to any one building. 

In buildings designated as conservation-of-vision schools, a 
room is set aside for the use of children with defective eyesight. 
A teacher is placed in charge of the room whose function it is to 
assist these children to keep pace with the boys and girls enjoy- 
ing normal eyesight. All written work is done in the special 
room. Practically all oral work is performed in the regular grade 
room with the other children. For example, a fifth grade child 
does his written arithmetic, map work, reading, written composi- 
tion, and writing with the special teacher. Oral arithmetic, 
geography, history, grammar, oral spelling, etc., are recited in the 
regular fifth grade room. This keeps the sight-saving class pupil 
in competition with those enjoying normal vision, and guards 
against the tendency to set special standards applicable only to 
special groups. 

Pupils of such classes, upon leaving school, regard themselves 
not as graduates of the special class, but of the school in which the 
class is located. Such pupils meet the world with a confidence 
which a training in competition exclusively with handicapped 
classmates could not possibly inspire. Furthermore, the em- 
ployer accepts without question the graduate of a regular public 
school whose standards are familiar to him, while the graduate 



1 8 HARVARD BULLETINS IN EDUCATION 

of a special class must assume the burden of proof, often in the 
face of actual prejudice. 

The plan of coeducation of conservation-of-vision pupils with 
pupils having normal sight offers many complications, and re- 
quires the careful supervision of a school authority who will keep 
constantly before all concerned the fundamental principle that 
school methods should be so planned as best to train the pupil for 
the broader field of life. 

The building selected for conservation-of-vision work should of 
course have good lighting conditions. The special room should be 
a model so far as eye-hygiene is concerned. The window-glass 
area should equal not less than one-fifth the floor area. In case 
of bilateral fighting, the walls containing windows should be adja- 
cent. The light coming from the rear in such rooms should be of 
less intensity than that coming from the left; otherwise trouble- 
some body shadows upon the desks may result. The more desir- 
able directions of the source of light are, in order of preference, 
northeast, east, north and east, northwest, north and west. A 
southern exposure should be avoided because of the glare and 
fluctuation in the intensity of light in south rooms. 

Windows should be provided with adjustable window shades 
which enable the teacher to exclude direct rays of the sun without 
darkening the entire window. When adjustable window shades 
are not used, the windows should be equipped with two shades, 
one at the top and one either at the bottom or at the top of the 
lower sash. 

An adequate scientifically planned artificial lighting system is 
essential for use on cloudy days. Semi-indirect lighting usually 
gives the best results. The best lighted sight-saving classrooms 
are provided with from two and one half to three watts of electric 
light power per square foot of floor area. 

Glare should be reduced to a minimum by refinishing the desks 
and all other woodwork with a mat surface. The walls should 
be decorated with a good neutral tint, preferably French gray, 
and should be done with calcimine or some other coating produc- 
ing a dull finish. Adjacent buildings should be sufficiently distant 
to permit a good sky line. Five vertical degrees of sky should be 




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20 HARVARD BULLETINS IN EDUCATION 

visible from every part of the room in which the children are 
required to work. 

The blackboard is the most essential part of the equipment of 
such rooms. The room should be fitted with good slate boards 
and a plentiful supply of blackboard cloth and desk writing- 
boards. 

The teacher of such a class should be under the constant advice 
of an eye specialist with whom she can counsel frequently regard- 
ing the ocular condition of each pupil. The amount of close work 
which any child may safely perform depends entirely upon the 
peculiar condition of his eyes. If any use at all is made of ordi- 
nary book print it should be upon the advice of the attending 
ophthalmologist. Most textbooks used in the conservation-of- 
vision classes are printed in a twenty-four point heavy type. An 
unglazed book stock paper, with a slightly buff tint, is employed. 1 

Written work in these classes is done largely upon the black- 
board. Certain pupils, however, are permitted to use a soft heavy 
pencil such as is commonly found in the first grade classrooms. 
The pencil work is done upon an unglazed manila paper, ruled at 
intervals of about an inch. The accompanying illustration shows 
a pupil working arithmetic problems upon such paper. He has 
drawn his movable desk up to the blackboard where he can see 
the problems which the teacher has placed on the board, and 
where he has very satisfactory light. 

Pupils above the fourth grade are taught to write on the type- 
writer, using the touch method. This enables them to do much of 
their written work without any eye strain whatever. In the ac- 
companying illustration the copy-holder containing the lesson for 

1 As sight-saving classes are still not very numerous, the demand for textbooks in 
large type is too small to make their production financially attractive to any com- 
mercial book-publishing concern. The need for such texts has been partially met by 
the Howe Publishing Society for the Blind, Old Court House, Cleveland, Ohio, 
which is a philanthropic organization interested primarily in printing books for the 
blind. This society has annually received orders from most of the cities conducting 
conservation-of- vision classes. By pooling this business it has been able to negotiate 
contracts with job printers and book binders for the publication at one time of the 
entire year's demand of the country. While the books which are sold by this or- 
ganization at cost are still quite expensive, the cost of production is far lower than 
would be possible were each city to do its printing independently. 




Sight-Saving Class Pupil Practising Typewriting 



22 HARVARD BULLETINS IN EDUCATION 

the day rests upon the floor and is independent of the typewriter 
stand. This eliminates the troublesome vibration inevitable when 
the copy-holder is attached either to the typewriter or to the 
table upon which the typewriter rests. 

The ordinary maps, such as are found in the geography text- 
books, and even wall maps contain so much detail and so much 
fine print that it is not safe to permit the sight-saving class pupil 
to make use of them. The outline maps which consist of lines 
drawn with paint upon slated cloth, showing the general political 
divisions, together with the rivers, coast lines, and other main 
physical features, are coming into general use in conservation-of- 
vision classes. On these maps it is possible to insert at will all 
necessary detail as needed. Such insertions may be erased and 
others made so that at all times the particular subject matter 
under consideration stands out clearly. 

Much emphasis is placed upon hand training in the sight-saving 
classes. These pupils are taught to use their hands without look- 
ing closely at what they are doing. It is hoped in this way to 
relieve them of much habitual eye-strain in their everyday occu- 
pations. 

The object of the sight-saving class would be but half attained 
were the teacher satisfied with enabling her pupils to do their 
school work with as little eye-strain as possible, and giving them 
thorough instruction in eye hygiene. The conservation of one's 
limited vision is not so much a matter of information as it is that 
of habit of life. This requires not only patient and persistent ex- 
planation and reiteration to the child, but also necessitates fre- 
quent visits to his home. It does little good for the teacher to 
copy the pupil's arithmetic in large script and to shield him from 
the evil effects of glare during the day, if by night he is permitted 
to attend the "movies" or to read the ordinary library books by 
the poor light usually available. A confidential and sympathetic 
relationship with the parents must be established and their intel- 
ligent cooperation enlisted. Then does the child's instruction in 
conservation-of- vision continue throughout all his waking hours. 

In order to measure the results of sight-saving class work two 
criteria may be used: (i) To what extent have these classes 



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24 HARVARD BULLETINS IN EDUCATION 

actually conserved vision? (2) How does the scholarship of the 
pupils in the sight-saving classes compare with their scholarship 
prior to assignment to such classes ? No extensive statistical 
study has yet been made of the effect of sight-saving class work 
upon the eyes of the pupils. A study of a small group by Dr. 
Louis Strieker of Cincinnati, has indicated most gratifying results. 
From general observation it seems clear that by relieving these 
pupils of eye-strain during the period of their school course, 
deterioration has been almost universally checked. Eye special- 
ists agree, however, that in most of the cases assigned to con- 
servation-of-vision classes, little improvement in eye condition 
should be looked for. The most that we may hope is that these 
pupils will get through school with little or no reduction of vision. 
Persons thoroughly trained throughout their school life in the 
care of their eyes may be expected to conserve their vision after 
reaching mature years. 

A study of the promotion records of 100 sight-saving class 
pupils in Cleveland shows a reduction of 85 per cent in the pro- 
portion of failures after the work in the sight-saving classes is 
well begun, as compared with the proportion of failures of these 
pupils prior to entrance in the sight-saving classes. The propor- 
tion of failures among the sight-saving class pupils is 60 per cent 
less than the proportion of failures in the entire public school 
system. 

Having brought these children through school with little or no 
diminution of vision, and having taught them to conserve their 
limited sight, the responsibility still rests upon the school to place 
them in occupations where they can attain a maximum of effi- 
ciency with a minimum of eye-strain. In most places, sight-sav- 
ing class pupils receive more or less aid in securing suitable em- 
ployment after leaving school. Cleveland added to its sight- 
saving class department a few years ago a vocational guidance 
worker. Her duties are briefly : to study the older boys and girls 
with a view to determining their vocational interests and pos- 
sibilities, and their social traits and characteristics; to suggest 
courses of study, and to visit the high school pupils in their class- 
rooms, conferring with their teachers in regard to their work and 




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26 HARVARD BULLETINS IN EDUCATION 

tendencies; to become acquainted with the families of these 
children, and to take an active interest in their social life. All this 
is done with a view to learning just how the individual can be- 
come an efficient, self-supporting, respected member of his own 
community. Furthermore, the vocational guidance worker finds 
"odd jobs" for the boys and girls who must work while attending 
schools. She calls upon business and professional men and 
women, and welfare supervisors in stores and factories, in an 
effort to interest them in her charges as wage earners. The aim is 
not merely to find simple processes which persons with defective 
vision can perform, but to discover lines of occupation in which 
they can safely engage with a limited degree of vision. Such oc- 
cupation should offer opportunities for advancement without 
injury to their eyes, general health, or morals. The vocational 
guidance worker's task does not end until each pupil is placed 
in the position for which he is best fitted by training and natural 
inclination, and is thus given a chance to prove himself socially 
and industrially a successful member of the community. When 
such persons are satisfactorily placed, the public school sight- 
saving class department has fulfilled its obligations. Thenceforth 
it is the duty of a publicly supported employment bureau to 
undertake this responsibility. 

The spread of the sight-saving classes to the smaller cities has 
given an opportunity to compare the prevalence of defective eye- 
sight in large and small places. In Cleveland there has been found 
one conservation-of- vision pupil to every thousand of the school 
population. The same ratio would seem to hold in Cincinnati. 
In Mansfield, Ashtabula, and Alliance, the ratio is about one to 
every five hundred of the school population. It is probable that 
this is a result of the special attention given to eyes by the medical 
inspection departments of our large cities. 

Considering for a moment the future development of this form 
of special school activity it would seem that the sight-saving class 
movement has just begun. The surprising proportion of children 
with defective eyesight in the smaller cities would indicate that 
every city having a population of 20,000 or more is in need of a 
class of this kind. 



SIGHT-SAVING CLASSES IN THE PUBLIC SCHOOLS 27 

Several attempts have been made by eye specialists to state in 
general terms the kinds and degrees of visual defect which indi- 
cate the need of some special school accommodation. Though the 
technical terms employed render these descriptions almost unin- 
telligible to the layman, two of these statements are appended as 
they will be of some assistance to eye specialists in determining 
which of their patients should be referred to sight-saving classes. 

Each individual applicant must, however, for the present be 
considered separately. As yet we can be certain only thus far: 
any child who has a defect of vision which makes it impossible, or 
inadvisable, for him to be instructed in the ordinary way should 
have some special school provision for his case. Any community 
which fails to do this must pay the price in dollars and cents for 
the loss of economic efficiency of certain of its citizens. 



28 HARVARD BULLETINS IN EDUCATION 



APPENDIX A 

Description of Eligible Candidates to Sight-Saving Classes 

Prepared by a Committee of Cincinnati Eye Specialists, of 

Which Dr. Louis Stricker was Chairman 

i. Children who cannot read more than 6/21 at distance and who 
cannot read 2.00 at 20 cm. 

2. Myopes who have more than five diopters of myopia. 

3. Hyperopes who have symptoms of asthenopia and who have more 
than five diopters of hyperopia. 

4. Children who have an astigmatism of more than 3.5 diopters and 
whose vision cannot be brought up to more than 6/24. 

5. Children with maculae, nebulae, leucomae, which interfere with 
sight and lead to eye-strain. 

Note. It is assumed that these conditions exist after the proper refractions have 
been made. 

Description of Cases Indicating Sight-Saving Class Treatment 

Prepared by Dr. Douglas F. Wood, of Minneapolis, After Some 

Study of This Subject 

1. Myopes of 8 diopters or more. 

2. Myopes whose vision cannot be brought up to one-half normal 
vision: 6/12. 

3. Progressive myopia. 

4. Children having macula or leucoma of the cornea; or optic 
atrophy with vision less than 6/15. 

5. Astigmatism with glasses 6/21 or less. 

6. Hyperopia with more than eight diopters, with symptoms of 
asthenopia. 

7. Keratitis. In the interstitial type, if the vision remains low after 
the eye has been quiet for three months, or in persistent recurrent 
conditions while under treatment. 

8. In congenital cataracts, or secondary cataracts where no acute 
condition is present, vision 6/15 or less. 

9. Congenital malformations, where the vision is 6/21 or less. 

10. In all chronic diseases of the fundus, where the vision is 6/12 or 
less. 



SIGHT-SAVING CLASSES IN THE PUBLIC SCHOOLS 29 



APPENDIX B 

A classification of the eye conditions of 181 Ohio pupils whose eye 
histories are available is arranged in the accompanying table. This 
distribution of cases will be of interest to any oculist investigating the 
subject of sight-saving classes, as it shows the actual proportion of 
various kinds of eye defects prevalent among the pupils now attending 
schools in the cities from which this material has been selected. The 
percentage of myopic cases is lower than we should expect to discover. 
It is probable that this fact is attributable to an undue conservatism 
among eye specialists in assigning to sight-saving classes extremely 
near-sighted pupils whose degree of vision can be brought up to near 
normal with glasses. The reluctance of oculists to assign such cases to 
sight-saving classes grows out of the difficulty of convincing the parents 
of the need of relieving the child of all eye-strain, in spite of the fact 
that with glasses he seems to see well and suffers no pain. Sight-saving 
classes would be able much more thoroughly to fulfil their function in 
the community if eye specialists would assign to these classes all cases 
of short-sight which they may be reasonably confident will become 
progressively worse when subjected to the strain which regular school 
work entails. 



30 HARVARD BULLETINS IN EDUCATION 

Classification of Diagnoses of Eye Conditions of 181 Sight-Saving 
Class Pupils in Ohio 

Eye Diagnoses Number of Pupils Per cent 

Albino 3 i -6 

Astigmatism 48 26.5 

Hyperopic Astigmatism 28 

Myopic Astigmatism 10 

Mixed Astigmatism 10 

48 

Buphthalmos (protrusion of the cornea) 1 .5 

Cataracts (an opaque formation in the crystalline lens) ... 20 1 1 .0 
Choroiditis (inflammation of the choroid, or coat of the 

eye containing most of the blood vessels) 9 4.9 

Congenital Malformation (imperfect development of 

retina) 1 .5 

Corneal Scars 21 1 1 .6 

Ectopialentis (dislocation of the crystalline lens) 3 1.6 

Glaucoma 1 .5 

Hyperopia (far-sight) 5 2.7 

Interstitial Keratitis (an inflammation of the cornea) .... 12 6.6 

Myopia (near-sight) 28 15.4 

Nystagmus (a condition in which the eye is continually 

moving) 19 10.5 

Optic Atrophy (paralysis of the optic nerve) 6 3.3 

Retinitis (inflammation of the retina) 4 2.2 

Retinitis pigmentosa 2 

Choroid retinitis 2 

4 

Distribution of Degree of Vision Possessed by 181 Sight-Saving 
Class Pupils in Ohio 

Degree of Vision Number of Pupils Per cent 

5/6o 6 3.3 

6/60 32 17.6 

6/9 4 (myopes) 2.2 

6/21 25 13.8 

6/15 17 9-4 

6/12 , 7 (myopes) 3.8 

6/30 25 13.8 

6/24 24 13.2 

6/18 14 7-7 

6/36 26 143 

4/60 1 -5 

Note. In determining the degree of vision the test card is usually placed at 
6 meters (20 feet) from the patient, and he is asked to read all of the lines on the 
card visible to him at that distance. The top line should be visible to a patient 



SIGHT-SAVING CLASSES IN THE PUBLIC SCHOOLS 3 1 

having normal sight at a distance of 60 meters (about 200 feet); the second line 
should be visible at 30 meters (about 100 feet) ; the fifth line should be visible at 
12 meters (about 40 feet); the sixth line should be visible at 6 meters (about 20 
feet). The degree of vision of a patient who can read the top line only is expressed 
as 6/60 vision, signifying that he can read at 6 meters what he should be able to 
read at 60 meters. The degree of vision of a patient reading only the first five lines 
is expressed as 6/12 vision, meaning that he can read at 6 meters what he should be 
able to read at 1 2 meters. A person having normal vision can read the sixth line at 
6 meters. His degree of vision is expressed as 6/6. Patients who cannot read the 
top line at 6 meters are frequently allowed to approach the card until this line be- 
comes legible; for example, a person who must approach to within 5 meters of the 
test card is said to have 5/60 vision, those who must approach to within 4 meters 
are said to have 4/60 vision. 

APPENDIX C 

Bibliography 

Report of Minnesota School for the Blind, 1910, p. 33. 

Report of Boston School Committee, 1913, p. 54; 1914, p. 32. 

Report of the Superintendent of Schools of Cleveland, 1913-14, p. 42. 

Report of Pennsylvania Institution for the Blind, 1914, p. 34; 1916, p. 109. 

Report of Massachusetts Commission for the Blind, 1914, P- 7°; I 9 I 6, 
pp. 16-49; 1916, P- °3- 

Report of United States Commissioner of Education, 1915, vol. i, p. 507. 

Report of Cincinnati Board of Education, 1916, p. 255. 

Report of Superintendent of Schools of Boston, 1917, p. 90. 

Cincinnati Board of Health Bulletin, September 18, 1915. 

Monthly Bulletin of Department of Health, City of New York, vol. ix, 
September, 1919, p. 220. 

Archives of Ophthalmology, vol. xliv, 1913, p. 186. 

Ohio State Medical Journal, vol. xiii, 1917, p. 813; vol. xiv, 1918, p. 81. 

American Journal of Public Health, vol. vii, 191 7, p. 782. 

Cleveland Medical Journal, vol. xvii, 1918, p. 245. 

Modern Medicine, July, 1918, vol. i, No. 3, pp. 257-264. 

W. C. Posey, "Hygiene of the Eye," 1918, p. 95. 

Proceedings of the American Association of Instructors of the Blind, 1916, 
pp. 12-88; 1918, pp. 58, 59, 60. 

Boston Transcript, May 20, 1916. 

Ohio Teacher, vol. xxxviii, 1916, p. 32. 

Outlook for the Blind, vol. x, 1916, p. 9; vol. xii, 1918, pp. 67-71. 

Cleveland Society for the Blind, "The Blind in Cleveland," 1918, p. 42. 

Louis Strieker, "Blindness in Hamilton County," 1918, pp. 66-91. 

Publication of the National Committee for the Prevention of Blindness, No. 
18, "Manual for Conservation of Vision Classes," by Winifred Hatha- 
way, November, 191 9. 

Attention is especially called to the "Manual for Conservation of Vision 
Classes," which should be in the hands of every sight-saving class teacher. 



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